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Reasons Claims are Denied #3 – Surveillance

July 5, 2009, by Mark Yazdani

Surveillance is a common tool used by disability insurance companies during the adjudication of a disability claim. The insurance company will hire an investigative firm to secretly take photos and video footage of a claimant and observe a claimant’s activities. If the insurance company believes the surveillance proves the claimant is capable of working, then they will likely deny or terminate the disability claim.

Is activity noted on surveillance sufficient to justify the denial or termination of a disability claim? Certainly the answer would depend on the type, frequency, and duration of the activity, as well as the nature of the claimant’s disability. However, surveillance often has only limited relevance to the question of whether a claimant is truly disabled.

Firstly, surveillance is usually conducted over a relatively brief period of time – most commonly 3 or 4 consecutive days. If a disabled person is shown to be active during that time, it does not necessarily mean that the person is capable of being active all the time. Many disabilities are of fluctuating severity such that people have “good days and bad days”.

Secondly, activities shown on surveillance are usually brief in nature and not indicative of whether is someone is capable of working. Surveillance showing a person walking their dog in the morning, shopping for groceries, or mowing the lawn is usually not sufficient to prove that they are capable of working 8 hours per day at a full-time job. Also, the surveillance will not show what is happening inside a claimant’s home after they return from their activity – many individuals will be completely exhausted and unable to do anything else but rest.

While surveillance is often not relevant to the issue of whether a person is disabled, it can be relevant to the issue of a claimant’s credibility. If a claimant tells their case manager that their condition is so severe such that they are always bed-ridden, surveillance showing the claimant active outside their home will be damaging to the claimant’s credibility. Likewise, if a claimant states that they are unable to drive a car, video footage proving otherwise will be damaging to the claimant’s credibility. If the insurance company can establish a claimant is not credible, it will have a negative impact upon a claimant’s chance of success at a trial.

If your short-term disability (STD) claim or long-term disability (LTD) claim has been denied on the grounds of surveillance evidence, do not lose hope. A court of law may strongly disagree with an insurance company’s interpretation of surveillance data. Also, in some cases, the investigator may have obtained footage of the incorrect person. Contact my office for a free consultation with an Ontario disability lawyer regarding your legal rights.